Don’t base health bill on stereotype

The new mental health Bill before government should not be a regression from the imperfect Mental Health Act of 1987. A sign of the flaws in the premises behind the conceptualisation of the new Bill is found in its stated objectives, one of which is to ‘protect society’ from the presence of potentially dangerously mentally ill persons. The central purpose of the Bill would be better served if it was, instead, to protect the mentally ill from a dangerous society. In sticking thus with a stereotype, this ‘objective’, so stated, is not only less than professional but also spreads a calumny, with it having been statistically demonstrated that mentally ill persons are no more or less dangerous than the ordinary population. Indeed, 2013 is the year when some of the central tenets of psychiatric theory have been questioned from within psychiatry itself, as they have been for several years from outside it. The latest version of the Diagnostic and Statistical Manual of Psychiatric Disorders has been a source of controversy giving credence to the view that many of the so-called mental diseases are in fact manufactured categories, with random and superficial behaviour labeled as new diseases such as ‘premenstrual dysphoric disorder’, a fancy label for the discomfort women might feel at the time of menstruation.

At the heart of the criticism is psychiatry’s central theory of chemical imbalances within the brain being responsible for dysfunctional behaviour. Unfortunately for psychiatry, this central tenet has never been proved, with brain chemistry being too complex for present day science to unravel. Indeed, scholars have long argued that the true causes of the personality breakdowns are social and economic, such as chronic poverty, unemployment, marital discord and an uncaring society. Concerned observers have been worried at the increasing ‘medicalisation of social problems’ which has been aided by the unholy alliance between big pharmaceutical companies and mental health doctors with both profiting illicitly and immensely at the expense of patients. Psychiatry has been cruel to patients in its history and much has not changed. The new Bill must protect patients from over-treatment as also human rights violations in mental health institutions. It must not fall into the trap of ‘over-legalisation’ of mental health at the expense of patients.